Although glucocorticosteroids are considered the first-line treatment in sarcoidosis, refractory cases require alternatives, such as methotrexate (MTX). A systematic literature search was conducted and combined with the opinions of sarcoidosis experts worldwide to formulate the recommendations. Randomized controlled trial evidence supporting the use of MTX in sarcoidosis was limited. Forty-five per cent (113 of 250) of the sarcoidosis experts contacted completed the survey (Europe 55%, North America 26% and Asia 12%). Ten recommendations were formulated concerning the indications for use, starting dose, folic acid, work-up, contraindications, monitoring, administration options in case of adverse gastrointestinal effects, hepatotoxicity, long-term safety and use during pregnancy and breast feeding.Ten multinational evidence-based recommendations for the use of MTX in sarcoidosis were developed, which are supported by the world's foremost sarcoidosis experts. In: "Multinational evidence-based WASOG recommendations for the use of methotrexate in sarcoidosis: integrating systematic literature research and expert opinion of sarcoidologists worldwide" by Cremer et al.
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To inform you about sarcoidosis and other ild in different countries we ask colleagues from all countries to summarize relevant facts (prevalence, the research and important websites, etc) of sarcoidosis and other ild. These "fact sheets" are published on our website.
We would like to ask the collaboration ofleading experts from countries still missing on our website to send us their contribution. Please look at some of the other countries for examples and the required format.